摘要
本文对54例慢性肺心病呼酸并发低Cl^-血症的临床资料进行了分析。根据酸碱失衡的类型,血清电解质和血浆渗透压的改变,将低Cl^-血症分为三型。Ⅰ型为单纯呼酸代偿性低Cl^-血症,19例(35%);Ⅱ型为呼酸并发代碱型低Cl^-血症,21例(39%),该型又分为正常血K^+(A)和低血K^+(B)两个亚型;Ⅲ型为呼酸代碱,重度低渗型低Cl^-血症,14例(26%),该型也分为正常血K^+(A)和低血K^+(B)两个亚型。对各型低Cl^-血症的发病机制进行了探讨。我们认为低Cl^-是引起和维持代碱的主要原因,低K^+是次因。治疗原则补Cl^-为首选,必要时适量补K^+。
The clinical findings of 54 patients with chronic cor pulmonale associated with respiratory acidosis and hypochloremia were analyzed. According to the types of acid-base disorders, changes of serum electrolytes and plasma osmotic pressure, hypochloremia was divided into three types. Type Ⅰ, compensatory hypochloremia with simple respiratory acidosis, occurred in 19 patients (35%); type Ⅱ, hypochloremia with respiratory acidosis and metabolic alkalosis, occurred in 21 patients (39%); type Ⅲ, severe hypoosmotic hypochloremia with respiratory acidosis and metabolic alkalosis, oc- curred in 14 patients (26%). Type Ⅱ and Ⅲ were divided into two subgroups, A (with normal serum potassium) and B (with hypokalemia). We discussed the pathogenesis of different types of hypochloremia, and consider that chloride depletion is the main cause of inducing and sustaining metabolic alkalosis, and potassium depletion is less important. Accordingly, the treatment is mainly directed to chloride replacement. Appropriate potassium administration is indicated when necessary.
出处
《中国危重病急救医学》
CSCD
1990年第2期89-91,128-129,共5页
Chinese Critical Care Medicine
